197417594-6-10-2025-12-CC-CHEH-DHHTXV-20250610150747

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197417594
Report Date: 06/10/2025
Date Signed: 06/10/2025 03:08:47 PM

Document Has Been Signed on 06/10/2025 03:08 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	A PLACE OF OUR OWN LEARNING ACADEMY,INC		FACILITY NUMBER:	197417594
ADMINISTRATOR/ DIRECTOR:	ADAMS, ALLEA		FACILITY TYPE:	840
ADDRESS:	2739 W. AVENUE L		TELEPHONE:	(661) 718-3614
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY: 43	TOTAL ENROLLED CHILDREN: 43	CENSUS: 9	DATE:	06/10/2025
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:59 PM
MET WITH:	Adrienne Tolliver		TIME VISIT/ INSPECTION COMPLETED:	03:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 6/10/2025, Licensing Program Analyst (LPA) Carol Heath met with the facility director, Yesica Aparicio to conduct an annual inspection for the school-age program. LPA toured and inspected the facility using the facility sketch. During today’s inspection, 9 school-age children, one teacher, and the director were present. There is one school-age classroom. The facility operates from Monday through Saturday, 5:00 a.m. to 8:00 p.m. Incidental Medical Services (IMS) were discussed. Physical Plant: LPA toured and inspected the classroom for students of school age. Furniture and equipment were inspected for age appropriateness and good repair. The room was observed to be clean and safe. The child care center is clean, safe, sanitary, and in good repair; all outdoor and indoor passageways, stairways, inclines, ramps, open porches, and other areas of potential hazard are kept free of obstruction; floors of all rooms have a surface that is safe and clean, cleaning compounds inaccessible, poisons locked, furniture/equipment is good condition, free of flies, other insects, rodents; tables/chairs provided to meet children’s needs; all play equipment and materials used by children are age-appropriate, each child has an individual permanent or portable storage space (cubby, individually labeled with name) for their clothing, personal belongings (stored separately). There is a working telephone.

Claretta Yates	TELEPHONE: (661) 202-3407
Carol Heath	TELEPHONE: (661) 202-3709
	DATE: 06/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: A PLACE OF OUR OWN LEARNING ACADEMY,INC	FACILITY NUMBER: 197417594
	VISIT DATE: 06/10/2025

NARRATIVE

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Telephone service was verified. Heating, lighting, and ventilation are adequate. There are cubbies with the children's photos and names for personal belongings. LPA observed age-appropriate toys, equipment, and materials. Drinking water is available inside the classroom through a dispenser and disposable cups. The trash can have a lid.
Restrooms: LPA inspected and observed one toilet and one sink in the school-age classroom. Soap and toilet paper were readily available, and the water temperature was appropriate. No paper towels were observed in the children’s bathroom. The facility has a surveillance system on the premises that covers each classroom and the outside play area. The fire extinguisher, smoke detector, and carbon monoxide detector were observed to be operable. A large emergency bin was observed inside the classroom, and an emergency backpack was beside the door.
The outdoor area: The facility features one playground for school-age children. LPA observed a basketball court accessible to school-age children. Outdoor play equipment was inspected for health, safety, good repair, and age appropriateness. There are concrete areas for active play. The area was observed to be debris-free from hazards, holes, broken items, debris, and cushioning material underneath. No bodies of water were observed. There are areas for shade and rest. School-age children have disposable water cups.
LPA observed a first aid kit with the required materials and supplies, a First Aid Kit menu in the office, fire extinguishers, and carbon monoxide detectors throughout the center. A fire drill and earthquake log are posted in the office, and a current Roster is available.
The parent board was reviewed and has posted the required forms. However, the facility will need to update LIC 610 and LIC 308. Fire/earthquake drills are currently. Children are inspected for illnesses upon arrival. A review of medication policy indicated that prescription medication is administered only with the parent's written permission. The Director administers medication and documents the dosage, date, and time on a log. Medication is brought and taken home by the parent daily.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 06/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2025

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: A PLACE OF OUR OWN LEARNING ACADEMY,INC	FACILITY NUMBER: 197417594
	VISIT DATE: 06/10/2025

NARRATIVE

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Medication is labeled correctly and stored in its original container. There are currently no school children in care with IMS needs. The director's office has a separate area for isolating and caring for ill children. A mat is available for sick children. An isolated toilet and sink are available for ill children in the office.
Sign-in and out processes were discussed and observed. The Teacher-to-child ratio was observed, and staff names were recorded. Care and supervision were evaluated to determine if children's basic needs were met and appropriate. LPA observed a parent board consisting of licensing-required postings—fire/earthquake drills, current.
Staff Records/Children's Records: The records of children and staff were reviewed. LPA verified that at least one staff member was present with current CPR and First Aid Training. All staff complete the Mandated Reporter training every two years. All staff members receive vaccinations for Measles, Pertussis, and Influenza. All staff members are required to undergo fingerprinting associated with the facility.
LPA observed that five children's files contained all required licensing documents.
Food Service: The kitchen at the facility on Ave L. is currently under repair. In the meantime, meals are being prepared at the Ave J. facility’s kitchen and brought to Ave L. The facility has a food program that provides meals and snacks to school-age children.
Cleaning solutions and other chemicals are stored in a cabinet above the sink, located near the lock-in classroom and the main building's maintenance room. Soaps, detergents, cleaning compounds, or similar substances are stored separately from food supplies. Drinking water is available inside the classrooms through water pitchers and disposable cups. Menus are posted at least one week in advance and made available for parents to review.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 06/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2025

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: A PLACE OF OUR OWN LEARNING ACADEMY,INC	FACILITY NUMBER: 197417594
	VISIT DATE: 06/10/2025

NARRATIVE

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The following general information was discussed during this inspection:
Immunization Requirements: §1596.7995 (a)(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a daycare center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
*All Licensing reports are available for review online and are considered public information. Summary: Assembly Bill 2621 added Section 1596.819 to the Health and Safety Code to require the Department to post certain licensing information for CCCs and FCCHs on its public internet website.
Fingerprint clearances and transfers: Before working or volunteering in a licensed childcare facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. If a fingerprint clearance has been obtained through the Department, Licensee may request a transfer of a criminal record clearance from one state-licensed facility to another using form LIC 9184
**Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements
Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed childcare facility are aware of situations that present the greatest danger to children
**The Center Director advised of the requirement to report unusual incidents and injuries to the parent/guardian and Licensing within the time frame specified by the regulation (call within 24 hours and submit a written report within 7 days) and on the form LIC624. The Center reminded to review updates/regulations and quarterly updates on the Department website. The "Notification of Parent's Rights" poster must be posted in an area of the center accessible to parents. The information regarding new legislation with regard to exemptions and parents' rights was also discussed.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 06/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2025

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: A PLACE OF OUR OWN LEARNING ACADEMY,INC	FACILITY NUMBER: 197417594
	VISIT DATE: 06/10/2025

NARRATIVE

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Criminal Record Clearance - Child Care Centers Licensee [or facility representative] was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
Lead Testing – Child Care Centers (CCC) CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES: Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
For the following scenarios use the below un-bolded language: • CCC COMPLETED TESTING AND IS IN THE PROCESS OF REMEDIATING LEAD EXCEEDANCES, or • CCC COMPLETED SAMPLING BUT THE TEST RESULTS ARE NOT YET AVAILABLE, or • CCC DID NOT COMPLETE TESTING PRIOR TO THEIR DEADLINE, or • CCC TESTING DEADLINE HAS NOT PAST LPA referred licensee [or facility representative] to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 06/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2025

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: A PLACE OF OUR OWN LEARNING ACADEMY,INC	FACILITY NUMBER: 197417594
	VISIT DATE: 06/10/2025

NARRATIVE

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CURRENTLY NEEDS IMS, USE AS FOLLOWS: Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
MyChildCarePlan.org – Centers and Family Child Care Homes Licensee [or facility representative] was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
Notice of Site Visit - Centers and Family Child Care Homes A notice of site visit was given and must remain posted for 30 days.

No deficiencies are being cited at this time; the facility complies with Title 22

An exit interview was conducted, and the report was reviewed with Director, Adrienne Tolliver.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 06/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/10/2025 03:08 PM - It Cannot Be Edited

Created By: Carol Heath On 06/10/2025 at 02:39 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: A PLACE OF OUR OWN LEARNING ACADEMY,INC	FACILITY NUMBER: 197417594
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/10/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(g)(1)

Personnel Requirements

(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above. During today's inspection, an assistant did not have his TB test in file. LPA asked the director to follow up with the front office (Ave J) to see if the assistant had submit his TB test result. The office was unable to find it, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/17/2025
	Plan of Correction
1 2 3 4	The assistant will complet his TB test and submit the result to the LPA by next Tuesday (6/17/2025)

Section Cited


	Deficient Practice Statement
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	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Claretta Yates
NAME OF LICENSING PROGRAM MANAGER:

TELEPHONE: (661) 202-3407

	Carol Heath
NAME OF LICENSING PROGRAM ANALYST:

TELEPHONE: (661) 202-3709

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/10/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2025

LIC809 (FAS) - (06/04)

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